title: Treatment of depression in type 2 diabetic patients: effects on depressive symptoms, quality of life and metabolic control.
abstract: OBJECTIVE
  Type 2 diabetes (T2DM) almost doubles the risk of comorbid depression, with lifetime prevalence up to 29%. Recognition and treatment of depression in T2DM are important because of its association with hyperglycemia, diabetic complications and poor quality of life (QoL). However, although currently available medical therapy for depression is effective in reducing depressive symptoms, it does not consistently improve HbA1c levels. The aim of this study was to determine the effects of antidepressant therapy on depressive symptoms, health-related QoL and metabolic control in T2DM.
  
  
  METHODS
  48 T2DM (47.8% males, age 59.8 ± 11.1, T2DM duration 9.5 ± 6.5 years) who had a major depressive disorder diagnosed with a Beck Depression Inventory (BDI) test score greater than 16 and confirmed with a structured interview, were prescribed citalopram 20mg once daily. 10 out of 48 refused the prescription and were used as controls. BDI score, BMI, HbA1c and the Spanish version of the SF-36 Health Survey were recorded baseline and after 6 months of treatment. Sociodemographic characteristics, complications related to T2DM and comorbidities were also recorded.
  
  
  RESULTS
  No differences in baseline characteristics were observed between the two groups. When compared with the untreated group (n=10), patients treated with citalopram (n=38) showed significant improvements in BDI score and in almost all areas of quality of life, except in general health and bodily pain. No differences in HbA1c, waist circumference or BMI were found.
  
  
  CONCLUSIONS
  Treating depressive symptoms with medical therapy in T2DM is associated with improvements in QoL and depression, but with no improvement in metabolic control or weight.
authors.affiliation: Endocrinology and Nutrition Department, Hospital Son Llàtzer, Spain. jnicolauramis@gmail.com
authors.forename: Joana
authors.initials: J
authors.lastname: Nicolau
authors.forename: Rosmeri
authors.initials: R
authors.lastname: Rivera
authors.forename: Carla
authors.initials: C
authors.lastname: Francés
authors.forename: Begoña
authors.initials: B
authors.lastname: Chacártegui
authors.forename: Lluís
authors.initials: L
authors.lastname: Masmiquel
mesh_terms: D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D015283:Citalopram / Q000627:therapeutic use; D003863:Depression / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000473:pathology* / Q000523:psychology*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram
keywords: Citalopram; Depressive disorder; Quality of life; Type 2 diabetes